Body image

Breast cancer surgery, whether it removes the whole breast or only part of it, can be a traumatic experience. Women react to and cope differently with their changed bodies, and the first few months are likely to be the most difficult. Here women discuss the feelings they had about their body image.

Although women emphasised the importance of treating the cancer, concerns about body image, self esteem and personal relationships were also considered significant in terms of making a full recovery. Woman who had a mastectomy often talked about their concerns about looking at the scar. Although some women looked at it shortly after the operation, one woman felt reluctant to look at her body and felt embarrassed when undressing in front of her husband. Like other women, however, she noted how these feelings receded with time.

Penny is a married training development manager. Ethnic background/nationality: White British.

The following morning, obviously they come round and they woke me up and the first thing they want you to do is up and about, which was fine. And the first thing I did was look down and I’d a, just a dressing going across here. And I just looked down and I thought, “Oh well that’s it.” And I think for me, because of being small busted, it wasn’t a huge, it wasn’t a, oh, I don’t really, I want to use the right words but it, I just thought “Well okay, there’s probably other people that perhaps it can affect a lot worse than I, than myself I think.” And I just looked at the dressing and thought right okay, that’s what I’ve got. There was a drain in as well which was, that was all fine. I got up and went in and had a shower and thought right okay, let’s get on with this now.

And at the time I got back into bed and had some breakfast and all the ward rounds and everything else. Visiting came, all my family came in. And I was great. We were chatting away. I was up sitting in a chair. I felt great, I had no pain. I just thought, “Right, that’s fine, let’s get on with it.” So that was on the Saturday and then, by the Sunday, they wanted to change the dressing. So I made sure my husband was there and the dressing was changed. So we both looked at the scarring together. Yes there was a scar and yes this was ten years ago, and I believe they do it differently now and I had a lot of stitches, but okay, you know it’s going to heal.

And then they let me out of hospital on the, oh I think I came out on the Tuesday.

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Profile Info

Age at interview:

68

Sex:

Female

Age at diagnosis:

59

And the surgeon said' "Now I want you to look." I says' "I cannot look at myself, I can't look at myself," because it was all stitched. I says' "No."

And then I'm saying to myself and I kept feeling this one and then here, and I said "Oh my God."

And every time, I must've said, I was turning my back on my husband you know. I would take a bath, I still couldn't look at this. I just used to get the sponge and do this to try and keep it clean and done all here and all here. And I still couldn't and it was about a month.

Even when I got the stitches out ten days after the op, I still couldn't look at myself and it was about a month after that when I started to look at my body. And I says, and I was looking in the mirror and I kept saying' "That's the most queerest thing I've ever seen in my life, it's so ugly." It really was, a woman with one breast. "Oh," I says. "No."

But then as time went on and I got fitted with this prosthesis I said, and I was looking in the mirror, I said' "Oh nobody will ever know."

And I said' "Oh, this is marvellous." But no I'm quite happy now.

That I've got the two breasts off, I'm not embarrassed any more with my husband, I don't turn my back on him. In fact he'll say to me' "They're lovely scars you've got," you know. So it doesn't bother me any more.

How women reacted to and coped with their new body image also depended on the appearance of the scar. A few women who had worked in the health field said they knew what to expect and did not feel overly shocked or upset. Other women felt that adapting to their new body image took some time but it does not cause any anxieties now.

I had no difficulties with my scars. I'm an operating theatre sister. I'm not typical you see. A scar is a scar, you know, that didn't worry me in the least.

I chose to have both breasts off and if you're asking was I grieving over the loss of my breasts frankly, no. I'd had them for the best part of my whole 70, 60 years. They'd been pretty young things at one time just as I was. But they've served their purpose. I'm more than a pair of boobs on legs for heavens sake.

I've never had a great big thing about it. I really couldn't care less frankly. The only reason I wear falsies, I wouldn't bother. But the only reason I do is because clothes are cut that way and your clothes look really peculiar if you don't.

But otherwise I just wouldn't bother, I truly wouldn't.

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Profile Info

Age at interview:

56

Sex:

Female

Age at diagnosis:

55

It took me, oh least a couple of months I think, to sort of have the courage to really look at it.

The incision has faded, I'm mean it's still there, you can still see it, but I don't look at it for any length of time, but it's not an issue any more.

But it did take quite a while to actually pluck up the courage to do that.

How did your husband feel about it?

Okay, I mean he always said, do what I wanted when it was sort of the option of the lump or the mastectomy. His view was I must do what I felt was best for me. So that was fine, I mean no problem.

We don't talk about it. I mean it's not an issue at all really. No, no. So I think I did the right thing in having the mastectomy to be honest.

Some women said they coped well with their new body image but, had they been younger, their concerns might have been different.

And so I opted for mastectomy because I had had calcification in that breast previously. And I thought well it's, you know, my breasts have served their purposes.

I've had two children, a long time ago. It's not a worry to me to lose it. And so I decided on that.

But again, it doesn't worry me one way or the other. And I certainly don't want to be reconstructed.

Although were I younger maybe I would. I certainly know, you know, I've known people who have been. People are different, and some women are very conscious of their shape and their profile. I suppose it's to do with self-image and well lifestyle as well, and of course with who you live with.

Some women said that that they felt comfortable showing their scar to other people, including family, friends and children.

Penny is a married training development manager. Ethnic background/nationality: White British.

My family were fantastic. My Mum and Dad came and stayed. I’ve got a sister that lives down in, away from me, down in Hampshire and she was on the phone every day. And then when I came out of hospital on the Tuesday, whichever day, that following weekend on the Sunday, it was a beautiful day and I had a house full of people. All of my husband’s family were visiting. They came down for the day. My sister and her husband came and visited for the day. I have a cousin that lives like an hour away, she came and visited for the day. And of course I’m one of these people, because I like, my background is catering as well, so I’m there trying to say to Mum, right we need to do this, this and this. “No you’re not doing anything.” And that, and they were making me sit down. And I went, “Oh no,” because I said, “Oh no they’re coming to my house,” you know, “You can’t do it all.”

But they were all running around doing everything, and amazingly when they came in they were very, they were going to me, “Hang on a minute, is it the same person? You look so well.” And I said, “Yeah, do you want to see my scar?” And I was showing everybody my scar. I didn’t care. Male or female, “Do you want to see it?” I was on the face of it sensitive to that, but to me it was important that, “Look I’m, you know, here I am, I’m still the same person, nothing’s changed.”

Several women said they accepted that a mastectomy was the best option for them but the impact of it struck them later when they needed to think more carefully about what they could wear.

Penny is a married training development manager. Ethnic background/nationality: White British.

Then after that I had my holiday. I look back and wonder how I did it, but I did do it. And my Mum helped me pack. And that’s where things became, perhaps hit home a little bit more for me because suddenly I couldn’t wear my bikini. Well I could, you know who cares? But I had to think about this now. Summery tops, strappy tops, gosh what am I going to wear? And I didn’t really know much about mastectomy clothes then. And my husband had read an article about a local place to where I live that did mastectomy wear.

And so I rang them up and went over there, and I said, “Right, this is the situation.” And they were lovely, lovely, two lovely ladies. And they showed me lots of different bras, and ten years ago I have to say the bras weren’t the prettiest of bras, very thick straps and that. But it was to hold your prosthesis in. And at this stage I just had what they called a softie. So it wasn’t particularly brilliant, and they showed me some swimsuits and swimwear, and it was very expensive. I remember it being so expensive. And I’m thinking, “This is crazy, there’s many of us out there,” and they were charging all this money. “But what can I do? I have to go with it.”

So I bought I think a bra and a bikini I think it was, and anyway it was just to get me through my holiday. And I’ve gone off on my holiday and had a great time.

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Profile Info

Age at interview:

47

Sex:

Female

Age at diagnosis:

37

Background:

Penny is a married training development manager. Ethnic background/nationality: White British.

When I look back, at the time there was no pretty underwear. There was no lovely strappy tops, things weren’t pocketed, and you had to really think about the cut of your clothes. And I think for the younger lady in her twenties, and I certainly felt this being at thirty seven, if I put a t-shirt on or a V t-shirt, I had to think about when I leant forward because of the prosthesis in the bra, the weight pushed your forward so all you could see was this hollow. And it was being able to wear things that didn’t happen like that. So you became, you started wearing things underneath clothes so you got like a little lace bit showing, which now you can get quite a lot of, and a lot of the mastectomy bras now have the lace bit put in. Which is brilliant but at the time you didn’t have this.

And evening wear, oh a nightmare for evening wear. To find a really lovely black dress that you could wear, no difficult. And not so much now because I think, because the underwear now is complementing what you can get. So you can get halter neck bras and things.

A few women explained that their feelings towards their new body image were bound up with the side effects of treatments, such as weight gain and hair loss. Several women also discussed rebuilding their confidence after the illness. Some women took part in support group fashion shows, and others discussed the possibility of further breast surgery for cosmetic purposes. One woman described having laser surgery to improve the appearance of her scar, allowing her to wear a greater variety of clothing.